|
Mechanical Permit Application
<br />
<br />Appl. Recd:., ~-~
<br />By: . / ......
<br />Date:
<br />
<br /> MARION COUNTY
<br /> DEPT. OF BUILDING INSPECTION
<br /> Senator Building # 225
<br /> 220 High St., N.E 2nd Floor
<br /> Salem, Oregon 97301
<br />R.H. WlTHROW, BLDG. ADMINISTRATOR
<br />588-5147 -- 588-5148
<br />5:00 P,,M.. ............ CODE-A-Phone 588.5373 ............. 8:00 A.M.
<br />
<br />Mechanical Permit Application
<br />
<br /> BId9. Permit No,,
<br />Mechan,oa, Perm, ?/
<br /> Date: 9-?
<br />
<br />Type of Permit:
<br />
<br />Address;
<br />
<br />Owner:
<br />
<br />Bldr. & No,,::
<br />
<br />Plans by:
<br />
<br /> Gas line for mobile home ~torago only)
<br />7831 Bishop ~-o?,~ S. £. ~tnlsville
<br />
<br />Phone::
<br />
<br />Phone:
<br />
<br />Phone:
<br />
<br />Tax Lot NO;.
<br />Sec.__Twnshp.
<br />Address::
<br />Address:
<br />Address:
<br />
<br />Rge.
<br />
<br />Application is made for:
<br />
<br /> Appliance .........
<br /> . Make
<br /> BTU Input,
<br /> Vent Size,
<br />
<br /> Comments:,
<br />
<br />[] New Installation
<br />[] Addition
<br />
<br />Floor Area
<br />Fuel
<br />
<br />[] Replacement
<br />[] Gas Connection
<br />
<br />Approved By: f4~ SURCHARGE
<br />
<br /> ITEM NO, FEE AMOUN1
<br /> ...... For Issuance of Permit 10,00
<br /> New Install. Ls 10(J'0,000 BTU ..... 6,,00
<br /> Replacement Ls 100 000 BTU ........ 6.00
<br /> New Install. More 100,000 ,BTU ...... 7.50
<br />,Replacement More 100,000 BTU 6.00
<br />Ne? Install. Floor Furnac. e 6,,00
<br />Replacement Floor Furnace .... 6,,00
<br />New Install. Suspended Heater 6,,00
<br />Replacement Suspended Heater 6.00
<br />New Install. Wall Heater 6.00
<br />Replacement Wall, Heater 600
<br />New Floor Mounted Unit Heater 6.00
<br />....R. eplace Floor Mounted Unit Heater 6.00
<br />Boiler/C0mpr. 3 hp 100 000 BTU 6.00
<br />Boiler/Con, pr. 15 hp, 500,000 BTU 11..00
<br />.Boiler/Compr 30 hp 1,000,000 BTU 15.00
<br />BoJler/Compr. 50 bp, 1,750,0..00 BTU 22.50
<br />Boiler/Compr. Over 50 bp, 1,750.000 BTU 37.50
<br />Air Handiing Unit to lO.,000'~u ft. 4..50
<br />Air Handling Unlt over 10,000 cu.. ft. 7.50
<br />Evap.prative Cooler 4.50
<br />...Exhaust System Commercial 4.50
<br />Hood and Exhaust Commercial 450
<br />Domestic Type Incinerator & Wood Stoves' 7.50
<br /> Commercial or Industrial Incinerator 30.00
<br /> Gas Connection Without Appliance (1 to 4 each) 2.00 2 ~00'
<br /> Over 4- $800 Plus E~cl~ Additional ,50
<br /> Appliance or Acces$o~/to Any Heating or
<br /> Comfort,, Cooli~ S~stem NO ...... Covered Above ...... 460
<br />
<br />I agree to install according to the submitted plans and specifications, the laws of the State of Oregon and the Ordinances of
<br />Marion County Permit expires if work not commenced within 120 days I further expressly warrant that I comply with the provi-
<br />sions of ORS 701,005 to 701 125 because;
<br />( ) I am a registered contractor Or ( ) the authorized representative of a registered contractor.
<br />( ) The work will be performed by a registered contractor,,
<br />( ) I am performing work on a property I own or occupy
<br />(.) Other (please specify) ~-.,lZ~
<br />SIGNATURE OF APPLICANT:: ././b/~-''~ ~
<br />
<br />
<br />
|